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General NPI Number Information
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NPI Number | 1295515815
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Entity Type | Organization
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Legal Business Name | GLAM HEALTHCARE INC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3601 W DEVON AVE STE 106
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City | CHICAGO
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State | IL
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Zip | 60659-1216
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Country | US
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Telephone | 312-825-2477
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 W DEVON AVE STE 106
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City | CHICAGO
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State | IL
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Zip | 60659-1216
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Country | US
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Telephone | 312-825-2477
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LILLA DIRISU
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Credential | RN
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Telephone | 312-825-2477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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